Bone demineralization following urinary intestinal diversion assessed by urinary pyridinium cross-links and dual energy X-ray absorptiometry

被引:35
作者
Kawakita, M
Arai, Y
Shigeno, C
Terai, A
Okada, Y
Takeuchi, H
Konishi, J
Yoshida, O
机构
[1] KYOTO UNIV,FAC MED,DEPT RADIOL,SAKYO KU,KYOTO 606,JAPAN
[2] KYOTO UNIV,FAC MED,DEPT NUCL MED,SAKYO KU,KYOTO 606,JAPAN
关键词
acidosis; bone density; absorptiometry; photon; pyridinium compounds; urinary diversion;
D O I
10.1016/S0022-5347(01)65849-X
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Purpose: We investigated the acid-base balance and bone mineral status in patients with 3 types of urinary intestinal diversion. Materials and Methods: Of 46 men with urinary intestinal diversions 20 had a Kock pouch, 15 had an Indiana pouch and 11 had an ileal conduit. Acid-base balance was assessed by arterial blood gas analysis. Bone mineral status was measured by urinary pyridinium cross-links and dual energy x-ray absorptiometry. In addition, urinary deoxypyridinoline was measured in 79 patients. Results: Of the 46 patients 7 (15%) with the Kock pouch (1), Indiana pouch (5) and ileal conduit (1) had metabolic acidosis associated with significantly lower bone mineral densities (p < 0.05) and higher urinary pyridinium cross-links (p < 0.005) than did those with normal acid-base status. No difference was found in metabolic acidosis and bone demineralization among the 3 groups. Additionally, in 79 patients urinary deoxypyridinoline reached the highest level immediately postoperatively and then gradually decreased to the stable level within 1 or 2 years. Conclusions: Metabolic acidosis following urinary intestinal diversion results in bone demineralization. The types of diversion did not cause differences in metabolic acidosis and bone resorption. Bone has a major role in buffering acid overload in the early postoperative period.
引用
收藏
页码:355 / 359
页数:5
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